Provider Demographics
NPI:1568448272
Name:WHITE, BARRY M (DPM)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:M
Last Name:WHITE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 FOREST FALLS DR
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6999
Mailing Address - Country:US
Mailing Address - Phone:207-888-3640
Mailing Address - Fax:207-847-3000
Practice Address - Street 1:45 FOREST FALLS DR
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6999
Practice Address - Country:US
Practice Address - Phone:207-888-3640
Practice Address - Fax:207-847-3000
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPOD 1046213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0915250001Medicare NSC
MEU95792Medicare UPIN
MEMM6230Medicare PIN
MELX5339Medicare UPIN
MEU95792Medicare UPIN